Philosophy Ethics and Humanities in Medicine最新文献

{"title":"Is context considered in health inequity research and why? An examination of current trends in Ethiopia.","authors":"Belayneh Taye Gedifew, Lucinda Cash-Gibson, Endalamaw Tesfa, Behailu Atinafu Dessie","doi":"10.1186/s13010-026-00228-z","DOIUrl":"10.1186/s13010-026-00228-z","url":null,"abstract":"<p><strong>Background: </strong>Health equity research requires a comprehensive understanding of the historical, social, and political factors that contribute to health disparities. Ethiopia is a nation with a long political and economic history and a diverse culture, encompassing multiple health knowledge systems and traditional healing practices. This background context is essential for research, as the country faces significant health inequities among individuals and across community groups. This study aims to examine the consideration of context in health inequities research, with a focus on Ethiopia.</p><p><strong>Method: </strong>This study used a Systematic Review Literature followed by Critical Interpretive Synthesis (CIS). Using a systematic search, we identified potential texts for inclusion. We searched three electronic databases, PubMed, HINARI, and Google Scholar, for publications up to June 30, 2023. Then, through systematic analysis followed by critical interpretive synthesis and conceptual translation, we developed a synthesizing argument about the trends in health inequities research.</p><p><strong>Findings: </strong>Our systematic analysis and CIS reveal that a decontextualized approach dominates health inequity research in Ethiopia. This approach heavily relies on quantitative methods and repeatedly emphasizes wealth, education, and geographic location as key variables. Such emphasis obscures the underlying structural and political causes of inequity. Additionally, this decontextualized research is supported by a political economy of knowledge production that mainly depends on international funders and secondary data, which may prioritize measuring equality over pursuing meaningful equity.</p><p><strong>Conclusion: </strong>The dominant research approach on Ethiopia focuses on quantitative methods and lacks contextual insight. This approach yields evidence that is inadequate for addressing the root causes of health inequality and inequity, as it unintentionally reinforces the very disparities it aims to eliminate by prioritizing technocratic solutions over transformative ones. Therefore, a crucial shift in epistemology toward contextually grounded, mixed-methods research supported by interdisciplinarity and multidisciplinarity is necessary to generate the knowledge required for meaningful and equitable change in Ethiopia and similar LMICs.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond correlation and causation: epistemic caution, anomalous findings, and COVID-19 vaccine safety.","authors":"Alex S Siebner, Alberto Rubio-Casillas, Mikolaj Raszek, David Cowley, Mark Fabrowski, Marina Piscopo, Carlo Brogna, Vladimir N Uversky, Elrashdy M Redwan, Sylvia N Genova","doi":"10.1186/s13010-026-00232-3","DOIUrl":"https://doi.org/10.1186/s13010-026-00232-3","url":null,"abstract":"<p><p>The COVID-19 pandemic exposed science's adaptive strengths and epistemic limits. In fact, in the pandemic, mRNA vaccines are attributed to have saved millions of lives. The maxim \"correlation does not imply causation\" is an essential safeguard against premature causal inference. However, its use may become epistemically restrictive when the absence of established causality is treated as sufficient reason not to investigate (severe) vaccine adverse events. This article examines the conditions under which a valid cautionary principle may have contributed to premature epistemic closure. Thomas Kuhn's theory of scientific paradigms is used as one interpretative lens rather than as an empirical explanation of institutional behaviour. We argue that the correlation-causation distinction can shift from a heuristic of caution to an instrument of epistemic conservatism, reinforcing prevailing frameworks and discouraging exploration of anomalies. A published autopsy case report involving multifocal necrotizing encephalitis and myocarditis after BNT162b2 vaccination is examined as an illustrative and hypothesis-generating case, not as representative evidence of systematic institutional conduct. A qualitative approach using Bradford Hill's criteria provides partial, inconclusive evidence of a causal relationship while also exposing the methodological limits of the tool employed. The results of the analysis showed that one of the nine criteria demonstrated support of causality, seven were partially supported, and one did not support causality. The analysis suggests, but does not prove, a causal relationship between the BNT162b2 vaccine and multifocal necrotizing encephalitis. The absence of the nucleocapsid protein does not provide definitive evidence to demonstrate a vaccine origin. Analytical methods are described which can distinguish between the wild-type SARS-CoV-2 spike protein and the recombinant spike protein expressed following mRNA vaccination. The absence of evidence does not mean evidence of absence and we must keep an open mind to this when reviewing such evidence on causality.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Algorithmic gaslighting in healthcare: mechanisms, harms, and epistemic injustice in context.","authors":"Orhan Onder","doi":"10.1186/s13010-026-00235-0","DOIUrl":"https://doi.org/10.1186/s13010-026-00235-0","url":null,"abstract":"<p><p>Algorithmic systems are increasingly woven into healthcare, from triage applications to AI-enabled decision support tools. While such systems promise efficiency and diagnostic accuracy, they also perform a normative function: shaping whose knowledge is treated as credible, which symptoms matter, and how patient testimony is interpreted. This article introduces algorithmic gaslighting to name the patterned dynamic through which testimonial and hermeneutical injustices become recursively stabilized and internalized as patient self-doubt in algorithmically mediated clinical encounters. Building on feminist and disability bioethics accounts of medical gaslighting-where clinicians dismiss or reinterpret patient reports, often in gendered or racialized ways-I extend the analysis to algorithmic contexts. Drawing on Miranda Fricker's theory of epistemic injustice, I show how interlocking sociotechnical mechanisms-data violence, opacity, automated authority, and feedback loops-can displace patient credibility, constrain interpretive resources, and destabilize patient self-trust. These dynamics recalibrate epistemic agency, rendering patients as data objects rather than recognized knowers. To counter such harms, I propose a normative framework aimed at interrupting gaslighting dynamics in algorithmically mediated care, emphasizing rights to contestation, participatory design, critical audits, and shared responsibility. Recognizing algorithmic gaslighting helps safeguard trust, dialogue, and agency in the digital transformation of healthcare.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suffering, justice, and scarcity: philosophical reflections on the burden of cancer in LMICS using Nigeria as a case study.","authors":"Omolara Aminat Fatiregun, Oseni T Afisi, Boluwatife L Borisade, Foluke Sarimiye, Bola Ola, Jude Uzoma Ohaeri","doi":"10.1186/s13010-026-00229-y","DOIUrl":"https://doi.org/10.1186/s13010-026-00229-y","url":null,"abstract":"<p><p>Cancer represents a significant and growing public health emergency in Nigeria, where high mortality rates, late-stage presentation, inadequate infrastructure, prohibitive costs and pervasive stigma combine to produce a multidimensional crisis. While epidemiological data and health system analysis illuminate the scale of the problem, they fail to capture the deeper ethical, structural and existential realities that shape the lived experience of cancer. This paper employs key philosophical concepts, including distributive justice, social justice, structural violence, biopolitics, epistemic injustice, care ethics, existentialism, Ubuntu philosophy, vulnerability theory and the capabilities approach to analyze the complex realities of cancer in Nigeria. It is a critical reflection on the rationale for practices and policies that are often taken for granted, using the tools of formal philosophical inquiry, with a view to either grounding the practices in proper ethical understanding, or rethinking them along proper ethical lines. We argue that applying these philosophical frameworks reveal deep-seated inequities, challenges to patient agency, the corrosive effects of stigma rooted in epistemic failures, relational deficits in care, and the profound existential struggles patients and families face. By examining the interplay among scarce resources, cultural beliefs, systemic weaknesses, and fundamental questions of value and meaning, this paper argues that a philosophical perspective offers a roadmap for more humane, just, and culturally grounded reforms in cancer prevention, diagnosis, treatment, palliative care, and compassionate responses within the Nigerian context.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can health justice be measured? A normative reconstruction of health equity indicators.","authors":"Akbar Shahrivari","doi":"10.1186/s13010-026-00234-1","DOIUrl":"10.1186/s13010-026-00234-1","url":null,"abstract":"<p><strong>Background: </strong>Health systems commonly evaluate justice using quantitative health equity indicators such as healthcare coverage, financial protection, population health outcomes, and measures of the social determinants of health. These indicators are often treated as competing operationalisations of a single moral standard. This article argues that this assumption is conceptually mistaken because different indicators evaluate different normative objects rather than alternative dimensions of the same conception of justice.</p><p><strong>Methods: </strong>Using a comparative normative methodology, the article analyses six theories of justice that have significantly shaped contemporary debates in biomedical ethics and health policy. Through the principles of justificatory attribution and the Focal Attribution Procedure, families of health equity indicators are systematically attributed to the normative domains that provide their primary moral justification.</p><p><strong>Results: </strong>The analysis suggests that widely used health equity indicators do not approximate a single moral construct. Instead, they identify distinct evaluative objects corresponding to different conceptions of justice, including aggregate health welfare, fair opportunity, responsibility-sensitive disadvantage, collective health goods, human functioning, and structural disadvantage. Persistent disagreement over health equity indicators therefore reflects normative pluralism rather than empirical or methodological inadequacy. Building on this analysis, the article proposes a Layered Evaluation Model that preserves the conceptual distinction between normative domains while providing a coherent framework for interpreting health equity indicators.</p><p><strong>Conclusion: </strong>Because the normative domains of health justice are conceptually distinct, representing health justice through a single composite index risks obscuring the evaluative objects that different theories seek to protect unless the weights used to construct that index are made explicit and normatively defended. Health equity measurement should therefore be understood as a process of explicit normative interpretation rather than technical aggregation. By systematically relating empirical indicators to their primary justificatory foundations, the proposed framework offers a more conceptually coherent, philosophically grounded, and policy-relevant approach to the evaluation of health justice.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The foundational role of autonomy for brain-computer interfaces.","authors":"Florian Richter","doi":"10.1186/s13010-026-00231-4","DOIUrl":"10.1186/s13010-026-00231-4","url":null,"abstract":"<p><p>Invasive brain-computer interfaces (BCIs) pose a challenge for describing human-system interactions because they involve a depth of engagement that is difficult to disentangle. This is particularly problematic when clear authorship of decisions is needed. This presupposes that such devices might also decide autonomously in certain situations. Although the use and implementation of such devices are highly disputed in practical ethics, they seem to offer at least therapeutic benefits for persons with, e.g., Parkinson's disease. That is why it is indispensable to develop a conceptual framework that allows a description of the system's interactions with the human agent. The effects of brain-computer interfaces on patients are assessed empirically in studies and hypothesized on a more speculative level via thought experiments. A model to operationalize dimensions of agency, such as responsibility and privacy, has been proposed. Nevertheless, this model is inchoate if it is not related to autonomy, because it is widely assumed that autonomy is not only a characteristic of the human agent but also of the technological system (at least to a certain degree). Consequently, a more complete model is needed that classifies autonomy at different levels (operational, strategic, and moral). Technological systems can only operate on the first two levels because their behavior is based on dispositions within the scope of alethic modality, whilst human agency is based on deontic structures that are expressed via normative attitudes and statuses that cannot be reduced to alethic modality. This crucial difference can be used to develop methods for evaluating the ethical side of BCIs.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between swamps and malaria: a review of the studies titled The Sanitary and Social Geography of Turkey.","authors":"Cihat Tanış","doi":"10.1186/s13010-026-00230-5","DOIUrl":"10.1186/s13010-026-00230-5","url":null,"abstract":"<p><p>This study examines the multidimensional impact of infectious diseases on societies through the case of malaria, with particular emphasis on the anti-malaria campaigns implemented in Türkiye during the early Republican period within the framework of the studies titled The Sanitary and Social Geography of Turkey. These works constitute primary-source materials that systematically document the country's health conditions, social structure, and geographical characteristics during the early years of the Republic. In this study, data on swamps and malaria contained in these publications were analysed through a systematic document analysis and regional comparative approach. The findings demonstrate that the relationship between swamps and malaria varied considerably across provinces. While a strong positive association was identified along the Mediterranean and Aegean coasts and in the major river deltas, this relationship was substantially weaker in the high-altitude regions of Eastern Anatolia. Furthermore, the effectiveness of swamp-drainage programmes in controlling malaria remained limited due to factors such as fragmented implementation, recurrent flooding, and irrigation projects. The analysis also indicates that agricultural activities, particularly rice cultivation, contributed to the spread of malaria by creating artificial swamp environments. Consequently, malaria control emerged as a central policy domain during the early Republican period, becoming closely integrated with the state's broader strategies of nation-building and socio-economic development.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconceptualizing the ethics of diagnosis: a Foucauldian framework.","authors":"Antonia Sahm","doi":"10.1186/s13010-026-00227-0","DOIUrl":"10.1186/s13010-026-00227-0","url":null,"abstract":"<p><strong>Background: </strong>Traditional approaches in medical ethics have primarily focused on the consequences of diagnoses, emphasizing their impact on patients' lives, treatment options, and social perception. While this perspective remains indispensable, it is limited in its consideration of the conditions under which diagnostic categories are created and applied. However, understanding these processes is essential, as they shape not only individual patient experiences but also broader social norms and the framework conditions of health systems.</p><p><strong>Methods: </strong>Drawing on Michel Foucault's work, this paper examines the intersection between epistemic authority and ethics in the production of medical knowledge. Foucault's analyses of medicine reveal how diagnostic practices are not purely objective but are embedded in institutional frameworks that regulate the production and application of medical knowledge. This perspective resonates with recent discussions in medical ethics such as epistemic injustice. However, as these often converge with Foucault's ideas, his work provides a suitable basis for a comprehensive examination of the way in which diagnoses are handled.</p><p><strong>Results: </strong>Diagnoses are not merely neutral descriptions of objective biological phenomena, but emerge from specific epistemic and institutional frameworks that structure medical knowledge. A Foucauldian lens allows for the formulation of critical questions that encourage a shift in perspective, from evaluating only the consequences of diagnoses to interrogating the processes that produce and validate them. This approach highlights the ethical significance of medical epistemology itself and its influence on patient care, social norms, and health governance.</p><p><strong>Conclusions: </strong>Ethical analysis in medicine must extend beyond the immediate effects of diagnosis. Attention to the production and structuring of medical knowledge is necessary to fully understand how diagnoses influence patients' experiences, shape social expectations, and reinforce systems of power. With the help of a Foucauldian Shift, medical ethics can more comprehensively address the moral dimensions of diagnosis, moving from consequences to the broader conditions that generate them.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstructing Al-Farabi's ethical framework in contemporary bioethics: genetics, reproduction, and technological challenges.","authors":"Nurgul Tattibek, Meirgul Ungarova, Asset Kuranbek, Jakipbek Altayev","doi":"10.1186/s13010-026-00224-3","DOIUrl":"10.1186/s13010-026-00224-3","url":null,"abstract":"<p><strong>Background: </strong>Contemporary bioethics operates within pluralistic societies, where ethical reasoning is not confined to prescriptive frameworks but rather involves deliberation across competing moral perspectives. Although the dominant approaches remain largely Western, there has been an increasing interest in integrating non-Western philosophical traditions. This study examines whether Al-Farabi's ethical framework can contribute to contemporary bioethical discourse without assuming direct conceptual equivalence.</p><p><strong>Methods: </strong>The study employed a sequential mixed-methods design integrating lexical analysis, hermeneutic reconstruction, and empirical validation. A corpus of seven key works by Al-Farabi, including The Attainment of Happiness and The Virtuous City, was analysed to identify recurring ethical concepts. These concepts were then subjected to contextual hermeneutic interpretation and subsequently operationalised into survey constructs. Data were collected from 265 medical and bioethics professionals and analysed using ANOVA, Pearson's correlation, logistic regression, and chi-squared tests.</p><p><strong>Results: </strong>The findings indicate statistically significant, albeit weak, associations between the reconstructed ethical constructs of Al-Farabi and contemporary bioethical attitudes. The justice construct was negatively associated with the acceptance of gene-editing interventions (F(1, 263) = 4.02, p = 0.047; r = - 0.122; odds ratio (OR) = 0.78, 95% confidence interval (CI) [0.62-0.98], p = 0.041; chi-squared (χ²) test, 1 degree of freedom (df), p = 0.047). The virtue construct was positively associated with support for government involvement in reproductive policy (F(1, 263) = 4.18, p = 0.043; r = 0.124; OR = 1.21, 95% CI [1.01-1.45], p = 0.038; χ²(1) = 4.11, p = 0.043). A weak positive correlation was observed between justice and autonomy (r = 0.144, p = 0.019). Model fit remained low (Nagelkerke R² = 0.03-0.06).</p><p><strong>Conclusions: </strong>The results suggest a limited but consistent alignment between the reconstructed elements of Al-Farabi's ethical framework and contemporary bioethical reasoning. While these findings do not indicate conceptual equivalence, they support the inclusion of non-Western philosophical perspectives as complementary analytical resources in bioethics, particularly in deliberative and intercultural contexts.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An investigation of theoretical model of the relationship between discussion with families and the attitude toward organ donation in Iran: the mediating role of Spiritual Well-Being.","authors":"Hamid Sharif-Nia, Noushin Mousazadeh, Mahnaz Rakhshan, Roghye Nazari, Maryam Dehghani, Hamideh Hakimi, Setayeshi Jafari BenahKhalkhal","doi":"10.1186/s13010-026-00214-5","DOIUrl":"10.1186/s13010-026-00214-5","url":null,"abstract":"<p><strong>Background: </strong>There is still a serious imbalance between the number of organ donors and the number of patients on the transplant list. It is therefore of great importance to assess and strengthen resources to improve people's attitudes towards organ donation. This study examines the possible mediating role of Spiritual Well-Being (SWB) in relation to attitudes towards organ donation and family discussions in Iranian society.</p><p><strong>Methods: </strong>This is a cross-sectional study conducted in Iran in 2022. Participants included 316 members of the Iranian general population aged 18 years and older who participated in the study using convenience sampling methods. Data were collected using a demographic profile form, and the standardized Spiritual Well-Being Scale (SWBS) by Paloutzian and Ellisons, and two researcher-made questionnaire including Attitudes towards organ donation and discuss with family. The researchers used path analysis to analyze the mediation model. All the statistical analyses were done using the SPSS_AMOS 27 software.</p><p><strong>Results: </strong>The majority of participants were single professional women with a bachelor's degree. Pearson correlation test results showed a positive correlation between attitudes towards organ donation and family discussions (r = 0.522, p < 0.001). There was also a positive association between attitudes towards organ donation and SWB (r = 0.247, p < 0.001). Similarly, results indicate a partial association between family discussion and attitudes toward organ donation, which is influenced by the mediating variable SWB and family affected in a manner similar to that seen for the variable 'discussing with'. And 'attitudes toward organ donation' are mediated by varying SWB (B = 0.227, p < 0.009). SWB and discuss with family explain 30% of the variance.</p><p><strong>Conclusion: </strong>Attitudes toward organ donation were directly influenced by discuss with family members and improved by SWB accordingly. This study suggests that SWB is integral to attitudes towards organ donation in Iranian society.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}